Provider Demographics
NPI: | 1528202850 |
---|---|
Name: | JP MEDICAL SUPPLY |
Entity Type: | Organization |
Organization Name: | JP MEDICAL SUPPLY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/DIRECTOR OF OPERATIONS |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CHIKA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | IWUCHUKWU |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 713-995-6600 |
Mailing Address - Street 1: | 8700 COMMERCE PARK DR. STE. 205 |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77036 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-995-6600 |
Mailing Address - Fax: | 713-995-6602 |
Practice Address - Street 1: | 8700 COMMERCE PARK DR STE 205 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77036-7430 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-995-6600 |
Practice Address - Fax: | 713-995-6602 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-04-30 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 15 | 332B00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |